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Adverse events associated with the use of intravenous epinephrine in emergency department patients presenting with severe asthma

Putland, Mark and Kerr, Debra and Kelly, Anne-Maree (2006) Adverse events associated with the use of intravenous epinephrine in emergency department patients presenting with severe asthma. Annals of Emergency Medicine, 47 (6). pp. 559-563. ISSN 0196-0644

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Abstract

Study objective: We determine the rate of adverse effects associated with the use of intravenous (IV) epinephrine by infusion for the treatment of severe asthma in the emergency department (ED). Methods: This retrospective, structured, medical record review included adult patients who presented to the ED of Western Hospital between 1998 and 2003 and who were triaged as category 1, 2, or 3, had a discharge diagnosis of asthma, and were administered IV epinephrine in the ED. Patients were excluded if they were older than 55 years or if a diagnosis of asthma was not confirmed. The primary outcome measures were occurrence of cardiac arrhythmia or ischemia, local tissue ischemia, hypotension or hypertension, neurologic injury, or death related to epinephrine infusion. Results: Two hundred twenty episodes of care met the inclusion criteria. Adverse events occurred in 67 episodes (30.5%; 95% confidence interval [CI] 24.5% to 37.1%); however, most were minor and self-limiting. There were no deaths. Major adverse events occurred in 3.6% of cases (8/220; 95% CI 1.7% to 7.3%), including 2 cases of supraventricular tachycardia, 1 case of chest pain with ECG changes, 1 case of incidental elevated troponin, and 4 cases of hypotension requiring intervention. Conclusion: IV epinephrine is associated with a low rate of major and a moderate rate of minor adverse events in patients with severe asthma; however, a causal relationship has not been established. Further research investigating effectiveness, as well as safety, is warranted.

Item Type: Article
Additional Information:

Pulmonary/brief research report

Uncontrolled Keywords: intravenous epinephrine, IV epinephrine, cardiac arrhythmia, ischemia, local tissue ischemia, hypotension, hypertension, neurologic injury, epinephrine infusion, cardiac arrhythmia
Subjects: Faculty/School/Research Centre/Department > School of Biomedical and Health Sciences
FOR Classification > 1102 Cardiovascular Medicine and Haematology
FOR Classification > 1103 Clinical Sciences
Depositing User: Yimin Zeng
Date Deposited: 06 May 2013 05:14
Last Modified: 06 May 2013 05:14
URI: http://vuir.vu.edu.au/id/eprint/21529
DOI: 10.1016/j.annemergmed.2006.01.022
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Citations in Scopus: 20 - View on Scopus

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